The contribution of transfusion to HCV infection in England

Abstract

The English HCV lookback programme has identified some individuals with transfusion-transmitted HCV infection. The path from the collection of donations from HCV-infected donors to the identification of infected recipients was constructed. The probability of different outcomes at each branch was derived from data collected during this programme. This path of probabilities was then used to produce a complete estimate of the number of recipients infected by blood transfusions (dead and alive at the end of 1995) by re-entry of blood components that fell out of the lookback at various steps prior to recipient testing, and entry of components from HCV-infected donations that were never identified for lookback. Less than 14,000 recipients were estimated to have been infected with HCV during the decade prior to the start of donation testing. Over 60% of these were expected to have died by the end of 1995. Transfusion has infected a large group of individuals. However, this group constitutes a very small, and declining, proportion of all HCV infections in the population.

Pre-operative predictors of the requirement for blood transfusion following total hip replacement

“…In 26 patients the decision was made to transfuse blood during (13) or soon after surgery (13), all before the post-operative haemoglobin was measured. In general the patients who required transfusion were older, with a lower weight, height, pre-operative haemoglobin level and BMI than patients who were not transfused ( Table I); 186 of 626 women (30%) required transfusion, compared with 58 of 390 men (15%) (p < 0.001).…”

“…11 Blood transfusion also poses the risk of disease transmission with viral pathogens, hepatitis B and C, HIV, and human parvovirus. [12][13][14] Although patient pre-donation of blood has been shown to reduce the need for autologous blood transfusion, re-transfusion of autologous blood is not a risk-free solution; there remains an incidence of sepsis as a result of bacterial contamination of stored blood. 15 Recently there has been concern over the possible transmission of variant Creutzfield-Jacob disease through allogenic blood transfusion.…”

Recruiting individuals into the HTLV cohort study in the United Kingdom: clinical findings and challenges in the first six years, 2003 to 2009

“…Ever having had cystitis or kidney infection treated with antibiotics was one of the most commonly reported conditions; this was also reported amongst US blood donors [24], although the association in the multivariable models only remained statistically significant in HTLV-2-infected subjects. A range of autoimmune disorders have been associated with HTLV, including polymyositis [25] and arthritis [24].…”

“…A range of autoimmune disorders have been associated with HTLV, including polymyositis [25] and arthritis [24]. In our study, a relatively large number of participants reported having had arthritis, although without a suitable control group, it is not possible to say whether this was associated with HTLV infection or not.…”

Surveillance of Transfusion-Transmissible Infections

“…All blood services have lookback/traceback systems in place that are monitored and can give an indication of the frequency of TTIs. Transfusion-transmitted infections are very rare and generally are identified when testing is implemented, with infections rarely identified once testing is established [8,9], and transfusion accounts for only a small proportion of general population infections [10].…”